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Personal Assistant Application Form Submission

Title *: Mrs.
First Name *:
Last Name *:
Address 1 *:
Address 2:
Town *: cardiff
County *: south glamorgan
Postcode *:
Phone number *:
Please enter your email address for submission confirmation. *:
Reference number of job being applied for *:

I confirm that I have the right to work in the UK and am able to prove my eligibility status when required to do so. *: Yes

Please read the Job Description carefully before providing information in this Section of the Application Form. Give details of your previous employment or experience which you think would help you to do this job. *: Over the years i have supported individuals who have different support needs and requirements , i have worked within different enviroments , with in there own homes ,in a supported living and also in NHS enviroment , i have gained knowlege from training and from each individual Supporting individuals with learning disabilities and physical disabilities in the community . Day to day running of home and finances , assist with activities , lias with outside agencies and medical health care professionals , promote choices, Independence ,i have also worked with domicilary With the training i have done and qualifications i have gained NVQ level 2 and QCF level 5 , plus commited to care training within the NHS i have been able to share my knowlege work on own inititive in a safe way for both individual and myself and colleques .

What qualities do you think are important when working as a personal assistant with a disabled person? *: Everyone should be treated equal not matter what your abilities are or disabilities ,being individual focused at all times respect choices ,promote independance , confidentiality at all times , mindful of personal space, ensure that individual is at the focus of all decision making , keeping individual safe in there own enviroment .

How do you think you can contribute towards the needs and the independence of a disabled person? *: Over the last couple of years i have been a personal assistance to individuals I support individuals that are direct payment each have separate contracts Each individual has different needs and support requirements and ablilities , giving encouragement and building confidence ,assisting with activities ,independence choices ,assisting with daily living skills and keeping community presence and respect building confidence and self worth keeping contact with friends

What is it about PA work which appeals to you? *: As i have been a PA for a couple of years the appeal is that it is individual focused ,and individual choices at all times assissting with the wishes of the person and knowing that i am assissting to keep there independance the way they want and that any decision is the decision of the individuals wishes and choices

What are your hobbies/interests?: Family is very important enjoy spending quality time , going on walks, holidays learnig about different cultures meeting new people , enjoy watching sport i have a little dog called alby who is the focus and boss of the household enjoy quality time playing ball games with him

Would you consider a casual position if you are unsuccessful with this job? *: Yes

Do you drive? *: Yes

Are you a vehicle owner? *: Yes

Do you smoke? *: No

Are you able to undertake training? *: Yes

What days/nights are you able to work, or prefer to work? *: Days

Are there any circumstances which would prevent you from providing cover or swapping a shift? *: Yes

If you would like to expand on the answers given above? Please use the box below.: As being a PA already i have a committment to the hours and days that was agreed with individuals ,unless individuals were on holiday .

Name *:
Job Title *:
Address *:
Phone Number *:
In what capacity do you know this person (should not be a family member)? *:
Name *:
Job Title *:
Address *:
Phone Number *:
In what capacity do you know this person (should not be a family member)? *:
Is there is any such information you wish to disclose, relating to any cautions or convictions which will appear on your mandatory DBS check? *: No/

Please provide details if necessary:

I agree that there is nothing which would prevent me from doing this job. *: Yes

I consent to the above *: Yes

I agree that the information I provide will be posted to the Dewis CIL PA noticeboard (all personal information will be withheld).: Yes

What geographical area’s are you able to cover?: cardiff area

How many hours of work can you offer per week?: 18 hours per week

Please indicate the approximate times that you are available for work throughout the week.: Monday AM/Monday PM/Tuesday PM/Thursday AM/Thursday PM/Friday AM/Friday PM/
Further Information: